Zurichs Transplant Coverage Lifts Liability From Self-Insured Employers
Transplant insurance is being offered as an employee-benefit product by Zurich North America to cover an increasingly common medical procedure.
“Year over year, the number of transplants increases, and due to medical advancements we dont expect that to stop,” says Stephen Mueller, vice president for New York-based Zurich North Americas accident and health group.
As a result, he also foresees an increasing need for transplant insurance.
Zurich first introduced the product in late 2000 in a few targeted markets and offered it to the wider market in 2001, Mueller says.
To cover catastrophic risks such as transplants, a self-insured employer typically buys medical stop-loss insurance as a reinsurance layer, Mueller states.
A medical stop-loss policy is typically written on an annual basis. If an employee undergoes transplant surgery at the end of one policy year, those costs would certainly pierce the stop-loss layer in that year, Mueller notes.
But in addition, costs from the recovery, immunosuppressant drugs and possible re-transplantation could significantly impact the following years medical stop-loss policy, he indicates.
This leads to rate increases to employers on their stop loss, he says.
Zurichs managed transplant coverage stabilizes self-insured employers stop-loss medical program “by carving out the catastrophic transplant event from first dollar and managing the program for them,” Mueller states.
While Zurich sees interest in its product from large and small employers, most of its clients are Fortune 500 companies, which experience transplants more often, Mueller says. The coverage is typically purchased by self-insured employers with more than 500 employees and by managed care organizations with more than 500 employees, Zurich says.
“We get many calls from employers” that have had an employee undergo a transplant, saying, “they never want to go through another one because the financial and emotional impact can be so devastating,” he says.
Among the products features are:
Managed coverage of transplants through a network of preeminent academic medical centers such as Johns Hopkins and the Mayo Clinic.
100% coverage of approved organ and bone marrow transplants at the network facilities.
Immunosuppressant drugs for one year.